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Full text of "Rapid Population Growth Consequences And Policy Implications"

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timetables, and training programs and point to specific changes urgently needed in medical education and health employment conditions.
Tables can be constructed to show the savings in health services investments like those in Tables 8 and 9 for different rates of development and different rates of natality reduction (population growth). Table 10 is such a table covering the probable range of development goals and natality reduction rates in LDC's in the next 20 years. Requirements for different development goals are shown in column 2. Requirements for population growth without natality control are shown in column 3 for a fixed population growth rate of 3 percent per year. Requirements for lesser population growth rates as a result of natality control are given in columns 4, 5, 6, and 7 and the difference (savings) between them and column 3 are shown in columns 8, 9, 10, and 11. The savings for a country that wants to double its level of health services in 20 years and is able to reduce its average population growth rate for the 20 years from 3 to 2.4 percent per year equal the investment needed to produce and to maintain 41 percent of its initial level (e.g., of manpower and facilities). Expressed as reduction in the requirement or investment needed without natality control the figure would be much lessó15.5 percent.
Family Planning and Health Service Costs. Because health service cost projections for 1985 are not available, it is difficult to estimate the reduced investment costs for health services that might result from effective natality control programs. A good guess would appear to come from (a) projecting a nation's development budget to 1985 from recent past experience, (b) assuming that the percent of the development budget for health services in 1985 remains the same as, or increases slightly above, that in 1965, and (c) applying the average percent reduction for that country which would result from calculations like those in Tables 8 and 9. In many LDC's effective natality control could reduce the health services investment needed to achieve goals like those in Tables 8 and 9 by 10 to 50 U.S. cents per capita per year. The direct fiscal benefits for health services of an effective family planning program will certainly be far greater in countries that already spend large amounts on health services or already have high hospital care costs resulting from poorly performed illegal abortions, but such countries are almost by definition well along the scale from less to more developed countries.
If family planning program costs are projected from Table 5 on the assumptions that (a) availability of good services will be increased steadily, (b) the rate of increase of public utilization will slow up, and (c) the cost per user will rise, they can be expected to reach levels of 25 to 50 U.S. cents per capita per year or more.
To summarize, in most LDC's over the next 20 years, the reduction in investment costs in health services resulting from effective family planning is likely to be substantial but does not appear likely to equal the added costs of the family planning program.